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How to Improve Performance? Try Listening

Richard Afable, MD, MPH, July 25, 2016

As a physician and health care executive I have always been attracted to tools and devices that enhance our ability to achieve outstanding clinical outcomes.  Over the years I have gained more appreciation for a particularly simple tool –the human ear. 

Richard Afable, MD, MPH

The evidence is overwhelming. When we listen to others –patients, employers, physician partners and more –we do a much better job. This isn't always easy in health care. Unfortunately, we have spent a long time instructing people and engaging in one-way conversations. Additionally, we have introduced certain technologies that create more distance than connections.  However, if we do listen and hear what those we serve want and need, we can be truly outstanding health care providers.

Several years ago, St Joseph Hoag Health heard that consumers wanted health care to be more accessible and convenient.  With this in mind, we embarked on developing breakthrough programs that brought every day health and disease prevention to where people live and work.  Today we have St Joseph Hoag Health Wellness Corners in several local business and residential areas. The centers are tailored for customer needs.  While some focus mostly on medical care, others incorporate fitness and wellness programs which users have found helpful. This is health care that works for the consumer because it is convenient and suited to their lifestyles.

We have also heard customers asking us to introduce technology that makes their lives more convenient, similar to the way Amazon and other e-commerce enterprises have changed their retail experience. We think this makes sense, so we are now focusing on providing e-visits and digital applications that help patients manage their health.  We do not think that this effort involves copying retailers every step of the way.  Health care is much more than a retail transaction. We need to develop consumer-centric innovations that truly improve the patient experience. I believe there is enough capability and appreciation for the unique nature of our field to make digital health care truly remarkable.

We also need to listen to employers who want more value from their health care investment. In our community, we heard employers state a clear preference for working as a team with health care insurers, brokers and providers who all focus on keeping employees healthier and providing the services they need. As a result, we developed innovative partnerships that focus on the specific health risks of each employer group and develop tailored programs that address these concerns, resulting in better outcomes which will naturally reduce health care costs. It is a collaborative method of working with employers and it is proving effective in achieving better patient satisfaction, improved outcomes and greater affordability. Our experience has shown this is never a one size fits all approach, but one that responds to each employer group's needs. 

We can also benefit enormously from listening to physicians who deliver care.  Ultimately, we all want to provide quality care for our patients and our communities. With this in mind, we must work together to develop highly effective partnerships. At St. Joseph Hoag Health, our collaborative work includes enhancing the patient experience, pursuing population health and developing technology to keep patients and doctors connected. Additionally, when our health system looks at future strategies, we have doctors at the table.  And we work hard to maintain open communication with all of our physicians.  This partnership of mutual respect and shared goals will be even more integral as health care continues to change and evolve.

Perhaps most importantly, we must remain aware that everyone has a voice, especially those who lack access to care or who need services such as mental and behavioral health.  For these individuals and families, we need to listen and respond appropriately--with much greater urgency. As a society, we have progressed in the way we view mental health, yet we still do not give these issues the attention they deserve. We cannot ignore the fact that many individuals with mental health conditions and the majority of people with substance use disorders do not receive the care they need.

I believe health care will advance dramatically over the next five-to- ten years. For those who want a part in this transformation, my advice is to begin with a very basic action: Start by listening.

Richard Afable, MD, MPH

Richard Afable, MD, MPH is president and CEO of St. Joseph Hoag Health.

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